Can Ovulation Occur on September 27 After Last Period on August 20?

Is it possible to ovulate on September 27 if the last menstrual period was on August 20?

Hello Doctor, my last menstrual period was on August 20.
I usually have irregular cycles, typically exceeding 35 days.
I was diagnosed on September 1, and I couldn't detect ovulation using ovulation test strips until I finally got a positive result on September 27.
I arranged to have intercourse accordingly.
Later, on October 11, I tested positive for pregnancy with two lines on a home pregnancy test.
However, I noticed some brown discharge, so I went to the hospital for a check-up.
The doctor I saw that day was not an obstetrician, so she ordered a urine test and a blood test for HCG, both of which confirmed pregnancy with an HCG level of 90.06.
However, she calculated based on my last menstrual period and did not see a gestational sac on the ultrasound, stating that it was not normal.
I explained to her that I ovulated on September 27 and questioned whether that date should be used for calculations.

Question 1: Is it possible to have ovulated on September 27 with a last menstrual period of August 20?
Question 2: If I ovulated on September 27, is it possible that on October 11 the gestational age was too early to be seen on the ultrasound?
Question 3: If I ovulated on September 27, is an HCG level of 90.06 considered normal? Thank you.

Niming, 30~39 year old female. Ask Date: 2022/10/14

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, the gestational age is too early to visualize.
It is recommended to wait another week, and you should be able to see it then.
Wishing you good health.

Reply Date: 2022/10/14

More Info

To address your questions regarding ovulation timing and pregnancy, let's break down the information step by step.

Question 1: Can Ovulation Occur on September 27 After Last Period on August 20?
Yes, ovulation can occur on September 27 after your last menstrual period (LMP) on August 20, especially considering your history of irregular cycles. The average menstrual cycle is typically around 28 days, but cycles can vary significantly among individuals. Since you mentioned that your cycles are often longer than 35 days, it is entirely plausible that you ovulated later than the typical cycle would suggest. Ovulation usually occurs about 14 days before the start of your next period, but this can vary based on individual cycle lengths and regularity. Given your irregular cycles, ovulation on September 27 is a reasonable possibility.

Question 2: If Ovulation Occurred on September 27, Could the Ultrasound on October 11 Show No Gestational Sac Due to Early Pregnancy?
Yes, if you ovulated on September 27, it is very likely that the ultrasound on October 11 would not show a gestational sac. Typically, it takes about 6-7 days after fertilization for the fertilized egg to implant in the uterus, and it may take a few more days for the gestational sac to be visible on an ultrasound. If you ovulated on September 27, implantation would likely occur around October 4, and it may take until about October 11 or later for the gestational sac to be detectable. Therefore, the absence of a visible gestational sac at that point could be consistent with the timing of your ovulation.

Question 3: Is an HCG Level of 90.06 Normal if Ovulation Occurred on September 27?
An HCG level of 90.06 is within a range that can be considered normal for early pregnancy, especially if ovulation occurred on September 27. HCG levels can vary widely in early pregnancy, and they typically double every 48-72 hours in a healthy pregnancy. At around 4-5 weeks of gestation, HCG levels can range from about 5 to over 426 mIU/mL. Therefore, your HCG level of 90.06 could be consistent with early pregnancy, particularly if you are around 4 weeks post-ovulation.

Additional Considerations
1. Timing of Testing: If you are trying to determine the viability of the pregnancy, it is advisable to have a follow-up HCG test in 48-72 hours to see if the levels are rising appropriately. This can provide more information about the health of the pregnancy.

2. Ultrasound Follow-Up: If your HCG levels are rising as expected but the ultrasound still does not show a gestational sac, your healthcare provider may recommend a follow-up ultrasound in a week or so to reassess.

3. Irregular Cycles: Since you have irregular cycles, it is essential to communicate this with your healthcare provider, as it can affect the interpretation of ultrasound findings and HCG levels.

4. Brown Discharge: The presence of brown discharge can be common in early pregnancy and may not necessarily indicate a problem, but it is always best to discuss any concerns with your healthcare provider.

In summary, based on your provided information, it is entirely possible for you to have ovulated on September 27, and the subsequent HCG levels and ultrasound findings can be interpreted in the context of that timing. Always consult with a healthcare professional for personalized advice and follow-up care.

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